Data Exchange For Quality Measures Implementation Guide
3.1.0 - STU 3.1.0
US
Data Exchange For Quality Measures Implementation Guide
3.1.0 - STU 3.1.0
US
This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v3.1.0: STU 3) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions 
| Official URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/gaps-detectedissue-deqm | Version: 3.1.0 | |||
| Active as of 2021-04-23 | Computable Name: DEQMGapsInCareDetectedIssueProfile | |||
The DEQM Gaps In Care DetectedIssue Profile indicates that the measure reported has an open gap or a closed gap as identified in the gapStatus modifier extension.
This profile builds on DetectedIssue.
The following data-elements are mandatory (i.e data MUST be present).
Each must have:
DetectedIssue.codeDetectedIssue.evidence.detail either references the measure to which the detected issue applies by referencing the DEQM Individual Measure Report or references the GuidanceResponse resourceDetectedIssue.patient references the patient for which the detected issue appliesUsage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from DetectedIssue
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  DetectedIssue | 0..* | DetectedIssue | Clinical issue with action | |
  modifierExtension:gapStatus | ?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status |
 code | S | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Required Pattern: At least the following |
   coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
 system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |
 patient | S | 1..1 | Reference(QICorePatient) | Associated patient |
| evidence | S | 1..* | BackboneElement | Supporting evidence |
| detail | S | 1..1 | Reference(DEQM Individual MeasureReport Profile | GuidanceResponse) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| DetectedIssue | 0..* | DetectedIssue | Clinical issue with action | |
 implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
 Slices for modifierExtension | ?! | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| modifierExtension:gapStatus | ?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status |
| status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. |
 code | SΣ | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc. Required Pattern: At least the following |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |
| patient | SΣ | 1..1 | Reference(QICorePatient) | Associated patient |
| evidence | S | 1..* | BackboneElement | Supporting evidence |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| detail | S | 1..1 | Reference(DEQM Individual MeasureReport Profile | GuidanceResponse) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| DetectedIssue.status | required | ObservationStatus |
| DetectedIssue.code | preferred | Pattern: CAREGAP |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| DetectedIssue | 0..* | DetectedIssue | Clinical issue with action | |||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
 extension | 0..* | Extension | Additional content defined by implementations | |||||
| Slices for modifierExtension | ?! | 0..* | Extension | Extension Slice: Unordered, Open by value:url | ||||
| modifierExtension:gapStatus | ?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status | ||||
| identifier | Σ | 0..* | Identifier | Unique id for the detected issue | ||||
| status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. | ||||
| code | SΣ | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc. Required Pattern: At least the following | ||||
| id | 0..1 | id | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | id | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |||||
| display | 0..1 | string | Representation defined by the system | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| severity | Σ | 0..1 | code | high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient. | ||||
| patient | SΣ | 1..1 | Reference(QICorePatient) | Associated patient | ||||
 identified[x] | Σ | 0..1 | When identified | |||||
| identifiedDateTime | dateTime | |||||||
| identifiedPeriod | Period | |||||||
| author | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Device) | The provider or device that identified the issue | ||||
| implicated | Σ | 0..* | Reference(Resource) | Problem resource | ||||
| evidence | S | 1..* | BackboneElement | Supporting evidence | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code | 0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue. | |||||
| detail | S | 1..1 | Reference(DEQM Individual MeasureReport Profile | GuidanceResponse) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. | ||||
| detail | 0..1 | string | Description and context | |||||
| reference | 0..1 | uri | Authority for issue | |||||
| mitigation | 0..* | BackboneElement | Step taken to address | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| action | 1..1 | CodeableConcept | What mitigation? Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc. | |||||
| date | 0..1 | dateTime | Date committed | |||||
| author | 0..1 | Reference(Practitioner | PractitionerRole) | Who is committing? | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | ||||
| DetectedIssue.language | preferred | CommonLanguages
| ||||
| DetectedIssue.status | required | ObservationStatus | ||||
| DetectedIssue.code | preferred | Pattern: CAREGAP | ||||
| DetectedIssue.severity | required | DetectedIssueSeverity | ||||
| DetectedIssue.evidence.code | example | ManifestationAndSymptomCodes | ||||
| DetectedIssue.mitigation.action | preferred | DetectedIssueMitigationAction |
This structure is derived from DetectedIssue
Summary
Mandatory: 5 elements
Must-Support: 5 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Differential View
This structure is derived from DetectedIssue
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| DetectedIssue | 0..* | DetectedIssue | Clinical issue with action | |
| modifierExtension:gapStatus | ?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status |
| code | S | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Required Pattern: At least the following |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |
| patient | S | 1..1 | Reference(QICorePatient) | Associated patient |
| evidence | S | 1..* | BackboneElement | Supporting evidence |
| detail | S | 1..1 | Reference(DEQM Individual MeasureReport Profile | GuidanceResponse) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. |
| Documentation for this format | ||||
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| DetectedIssue | 0..* | DetectedIssue | Clinical issue with action | |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| Slices for modifierExtension | ?! | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| modifierExtension:gapStatus | ?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status |
| status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. |
| code | SΣ | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc. Required Pattern: At least the following |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |
| patient | SΣ | 1..1 | Reference(QICorePatient) | Associated patient |
| evidence | S | 1..* | BackboneElement | Supporting evidence |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| detail | S | 1..1 | Reference(DEQM Individual MeasureReport Profile | GuidanceResponse) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| DetectedIssue.status | required | ObservationStatus |
| DetectedIssue.code | preferred | Pattern: CAREGAP |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| DetectedIssue | 0..* | DetectedIssue | Clinical issue with action | |||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| Slices for modifierExtension | ?! | 0..* | Extension | Extension Slice: Unordered, Open by value:url | ||||
| modifierExtension:gapStatus | ?!S | 1..1 | DEQMGapStatusModifierExtension | Gap Status | ||||
| identifier | Σ | 0..* | Identifier | Unique id for the detected issue | ||||
| status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Indicates the status of the identified issue. | ||||
| code | SΣ | 1..1 | CodeableConcept | Issue Category, e.g. drug-drug, duplicate therapy, etc. Binding: DetectedIssueCategory (preferred): Codes identifying the general type of detected issue; e.g. Drug-drug interaction, Timing issue, Duplicate therapy, etc. Required Pattern: At least the following | ||||
| id | 0..1 | id | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | id | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ActCode | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: CAREGAP | |||||
| display | 0..1 | string | Representation defined by the system | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| severity | Σ | 0..1 | code | high | moderate | low Binding: DetectedIssueSeverity (required): Indicates the potential degree of impact of the identified issue on the patient. | ||||
| patient | SΣ | 1..1 | Reference(QICorePatient) | Associated patient | ||||
| identified[x] | Σ | 0..1 | When identified | |||||
| identifiedDateTime | dateTime | |||||||
| identifiedPeriod | Period | |||||||
| author | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Device) | The provider or device that identified the issue | ||||
| implicated | Σ | 0..* | Reference(Resource) | Problem resource | ||||
| evidence | S | 1..* | BackboneElement | Supporting evidence | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code | 0..* | CodeableConcept | Manifestation Binding: ManifestationAndSymptomCodes (example): Codes that describes the types of evidence for a detected issue. | |||||
| detail | S | 1..1 | Reference(DEQM Individual MeasureReport Profile | GuidanceResponse) | This references either a DEQM Individual MeasureReport or a GuidanceResponse resource. Note that referencing the GuidanceResponse resource allows potential profiling on GuidanceResponse in the future without breaking backward compatibility. | ||||
| detail | 0..1 | string | Description and context | |||||
| reference | 0..1 | uri | Authority for issue | |||||
| mitigation | 0..* | BackboneElement | Step taken to address | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| action | 1..1 | CodeableConcept | What mitigation? Binding: DetectedIssueMitigationAction (preferred): Codes describing steps taken to resolve the issue or other circumstances that mitigate the risk associated with the issue; e.g. 'added concurrent therapy', 'prior therapy documented', etc. | |||||
| date | 0..1 | dateTime | Date committed | |||||
| author | 0..1 | Reference(Practitioner | PractitionerRole) | Who is committing? | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | ||||
| DetectedIssue.language | preferred | CommonLanguages
| ||||
| DetectedIssue.status | required | ObservationStatus | ||||
| DetectedIssue.code | preferred | Pattern: CAREGAP | ||||
| DetectedIssue.severity | required | DetectedIssueSeverity | ||||
| DetectedIssue.evidence.code | example | ManifestationAndSymptomCodes | ||||
| DetectedIssue.mitigation.action | preferred | DetectedIssueMitigationAction |
This structure is derived from DetectedIssue
Summary
Mandatory: 5 elements
Must-Support: 5 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Other representations of profile: CSV, Excel, Schematron
IG © 2020+ HL7 International - Clinical Quality Information Work Group. Package hl7.fhir.us.davinci-deqm#3.1.0 based on FHIR 4.0.1. Generated 2022-11-21
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